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Exploring the Connection Between Infectious Disease and the Opioid Crisis

Friday May 11, 2018

This article appears courtesy of HIV.gov.

The opioid crisis in the United States is having a devastating impact on the lives of millions of Americans. Not only has it made drug overdose the leading cause of death among Americans under 50 years of age, its growing consequences have included an alarming rise in injection-related infectious diseases.

New hepatitis C (HCV) infections more than tripled between 2010 and 2016. Some communities that have been hardest hit have also seen increases in hepatitis B (HBV), HIV, and other infections such as endocarditis, septic arthritis, and abscesses driven by increases in the numbers of people who inject drugs. All of these result in escalating costs, both in human lives and in costs to health care systems.

The National Academies of Sciences, Engineering, and Medicine (National Academies) explored the relationship between the opioid crisis and increases in viral hepatitis and other infectious diseases at a groundbreaking one-and-a-half-day workshop on March 12 and 13 in Washington, D.C. The meeting was attended by a large audience that included more than 500 webcast viewers from across the country.

Through improved use and coordination of existing public health and medical systems, experts at the workshop encouraged more research and exploration of strategies for working with people who inject drugs that emphasize empathy, respect, and patient satisfaction.

At the start of the meeting, Assistant Secretary for Health ADM Brett Giroir, M.D. highlighted recent CDC data on increases in injecting drugs and HCV infections that underscore the severity of the health threats associated with opioid use and infectious diseases. He encouraged both experts and the audience by noting how we all can clearly quantify the infectious disease consequences of the opioid crisis and how we must envision and implement an aggressive new agenda for responding. ADM Giroir highlighted the importance of partnerships to encourage evidence-based changes and new and stronger collaborations, including among business and law enforcement, to effectively respond to the crisis.

Presenters discussed the scope of the problem, giving special attention to opportunities to prevent, test for, and treat the infectious diseases that are often spread through injection drug use, especially those that can be put into place efficiently through the existing public health and medical systems. These expert presentations can serve as a starting place for a dialogue about the evolving needs of communities and individuals impacted by the opioid crisis.

It is important to remember that real people's lives are affected by our efforts to address the opioid crisis as well as the related infectious diseases. The workshop also included Veda Moore from Baltimore, Maryland, to share a patient's perspective. Ms. Moore told her personal story of her struggle with addiction, of learning that she had HIV, and, after several attempts, had the opportunity to enter a drug treatment program and simultaneously realized that she was ready to change her life for the better. Sharing her experience required bravery, but Ms. Moore did in order to help others who may face similar challenges like she had in her youth. Today, she has completed college and works to help others affected by addiction and associated infectious diseases get to that same place where opportunities for drug treatment and the will to create a better life, free of addiction, exist.

The human toll of the opioid crisis is staggering, and there is much work to do. The experts who presented during the workshop provided a variety of potential solutions grounded in science and data. We hope that all people working to respond to the opioid crisis will consider how they can expand the impact of their efforts through partnerships with other organizations in order to provide the full range of opportunities needed to help people who are facing addiction and infectious diseases.

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